Individual
DR. PAUL DAVID NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
308 MAIN ST, JANESVILLE, IA 50647
(319) 987-3080
(319) 987-3080
Mailing address
PO BOX 130, JANESVILLE, IA 50647-0130
(319) 987-3080
(319) 987-3080
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
06453
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04192
WELLMARK BLUE CROSS BLUE
IA
05
—
2264465
—
IA
Enumeration date
11/08/2006
Last updated
05/14/2008
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